Article

Neurobehavioural disability (NBD) following acquired brain injury
undermines capacity for independent social behaviour and results in serious
long-term social handicap.
The presence of challenging behaviour as a feature of
NBD has obvious implications for rehabilitation and community reintegration.
OBJECTIVES: Behavioural approaches are seen by many as fundamental to the
successful rehabilitation of challenging behaviour. This paper will a) define the
nature of neurobehavioural rehabilitation; b) explore the characteristics of
cases referred, and c) the outcomes achieved. Strengths, limitations and future
developments of neurobehavioural approaches for challenging behaviour will be
considered along with potential factors that limit generalisation and longevity
of treatment gains. METHODS: Literature review. RESULTS: Neurobehavioural
services are distinguishable from other forms of neurorehabilitation. There is
considerable evidence supporting the central role of both positive behaviour
supports and contingency management approaches in creating conditions that
minimise neurocognitive impairment, facilitate new learning, and ensure a
positive social climate in both specialised inpatient units and community
settings. Possible limitations include over-reliance on evidence from successful
accounts of single cases and lack of knowledge regarding generalisation.
CONCLUSIONS: Neurobehavioural rehabilitation is effective and can save care costs
in the long term. More evidence regarding maintenance of gains is required.

Langue : ANGLAIS